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1.
Mediterranean-Style Diet for the Primary and Secondary Prevention of Cardiovascular Disease: A Cochrane Review.
Rees, K, Takeda, A, Martin, N, Ellis, L, Wijesekara, D, Vepa, A, Das, A, Hartley, L, Stranges, S
Global heart. 2020;(1):56
Abstract
BACKGROUND Diet plays a major role in cardiovascular disease (CVD) risk. OBJECTIVES To determine the effectiveness of a Mediterranean-style diet for the primary and secondary prevention of CVD. METHODS We searched for randomised controlled trials (RCTs) of Mediterranean-style diets in healthy adults and those at increased risk of CVD (primary prevention) and with established CVD (secondary prevention). RESULTS Thirty RCTs were included, 22 in primary prevention and eight in secondary prevention. Clinical endpoints were reported in two trials where there was moderate quality evidence for a reduction in strokes for primary prevention, and low quality evidence for a reduction in total and CVD mortality in secondary prevention. We found moderate quality evidence of improvement in CVD risk factors for primary prevention and low quality evidence of little or no effect in secondary prevention. CONCLUSIONS There is still some uncertainty regarding the effects of a Mediterranean-style diet in CVD prevention.
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2.
RISK-FACTORS OF CORONARY ARTERY DISEASE (REVIEW).
Kantaria, M, Buleishvili, M, Kipiani, NV, Ormotsadze, G, Sanikidze, T
Georgian medical news. 2020;(299):78-82
Abstract
The treatment of coronary arteries disease (CAD) and the prevention of their complications, intervention on the coronary arteries is usually recommended. In this review, with the aim of improving the treatment outcomes of patients with CAD, requiring percutaneous coronary intervention and/or coronary artery bypass grafting,risk factors of developing coronary syndrome are discussed. Understanding the causes of the disturbance of coronary artery conduction will provide a new perspective for improving patient treatment outcomes. Revascularization cannot protect against future acute thrombotic events; for the successful treatment of CAD combining optimal revascularization strategies with long-term measures of risk reduction in lifestyle, often in combination with pharmacological measures, is needed. Numerous primary and secondary prevention trials have shown that management of modifiable risk factors (reduction in LDL-cholesterol level, decrease in blood pressure, discontinuation of smoking) reduces death rates, myocardial infarction, stroke, and other cardiovascular events, including the need for revascularization. Refined guidelines for the primary and secondary prevention of atherosclerosis account for modifiable and nonmodifiable, and other emerging risk factors of CAD.
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3.
Prevention of recurrent urinary stone disease.
Goka, SQ, Copelovitch, L
Current opinion in pediatrics. 2020;(2):295-299
Abstract
PURPOSE OF REVIEW Urinary stone disease (USD) is increasing in prevalence and recurrence is common. In pediatrics, most stones are composed primarily of calcium with the highest incidence observed in adolescents. Given the morbidity associated with USD, an in depth review of current management strategies is of paramount importance to highlight the data supporting the recommended treatments and the knowledge gaps which still exist. RECENT FINDINGS Several interventions for the management of recurrent calcium USD in children have been recommended based on primarily adult studies. These interventions include modification of diet and fluid intake in addition to the utilization of medications such as thiazide diuretics and citrates when supportive care is inadequate. Overall there is conflicting data in the adult literature which is further complicated by our attempts to extrapolate these data to children. SUMMARY Based on the currently available literature the management of USD in pediatrics should be individualized to each patient and focused on the particular metabolic risk factors that are identified during the course of their evaluation. Several interventions may be required or trialed in a particular patient to show an effect. Well designed trials to assess the efficacy of each intervention in the pediatric population are needed.
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4.
Primary versus secondary cardiorenal prevention in type 2 diabetes: Which newer anti-hyperglycaemic drug matters?
Giugliano, D, Ceriello, A, De Nicola, L, Perrone-Filardi, P, Cosentino, F, Esposito, K
Diabetes, obesity & metabolism. 2020;(2):149-157
Abstract
We are observing a resurgence of major diabetic vascular complications after a period of dramatic decrease during the period 1990 to 2010. The classical division of cardiovascular prevention into primary (with an event) and secondary (without an event) is largely used to describe cardiovascular risk in type 2 diabetes (T2D); however, there is evidence that the cardiovascular risk in diabetes may range from highest in patients who experienced a previous cardiovascular event to mild in patients with the main risk factors at target. Herein, we present details of the 14 cardiovascular outcome trials (CVOTs) published to date, including the total population investigated, and their separation into primary (T2D + multiple risk factors) and secondary prevention (T2D + established cardiovascular disease [CVD]) populations as detailed within the trials. We also summarize evidence for the effects of dipeptidyl peptidase-4 inhibitors (DPP-4i), glucagon-like peptide-1 receptor agonists (GLP1-RA) and sodium glucose co-transporter-2 inhibitors (SGLT-2i) versus placebo on the risk of major cardiovascular events (MACE), heart failure (HF) and diabetic kidney disease (DKD). In primary prevention, SGLT-2i reduce both the risk of hospitalization for HF and progression of DKD; in secondary prevention, SGLT-2i are effective on the three endpoints, DPP-4i are neutral, while GLP1-RA show mixed results.
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5.
Vitamin D for secondary prevention of acute wheeze attacks in preschool and school-age children.
Stefanidis, C, Martineau, AR, Nwokoro, C, Griffiths, CJ, Bush, A
Thorax. 2019;(10):977-985
Abstract
INTRODUCTION Vitamin D is best known for its role in bone health; however, the discovery of the vitamin D receptor and the expression of the gene encoding the vitamin D 1α-hydroxylase (CYP27B1) enzyme in a wide variety of tissues including immune cells and respiratory epithelium has led to the discovery of potential roles for vitamin D in the prevention of acute wheeze. METHODS We review here the literature concerning the relationships between circulating 25-hydroxyvitamin D (25(OH)D) concentration and secondary prevention of acute wheeze attacks in preschool and school-age children. RESULTS Epidemiological data suggest that vitamin D insufficiency (25(OH)D <75 nmol/L) is highly prevalent in preschool and school-age children with wheeze. Preschool age children with a history of wheeze attacks and circulating 25(OH)D <75 nmol/L are at increased risk and frequency of future acute wheeze. However, no consistent association between low vitamin D status and risk of acute wheeze is reported in school-age children. Seven randomised controlled trials (RCTs) with relatively small sample sizes (30-430) and variable quality showed inconsistent results regarding the effect of oral vitamin D supplementation during childhood on the risk of asthma attacks, asthma symptom control, inhaled corticosteroid requirements, spirometry and unscheduled healthcare attendances for wheeze. A RCT showed that vitamin D supplementation had no effect on the frequency of unplanned healthcare attendances due to acute wheeze in 22 preschool children. DISCUSSION An evidence-based recommendation for the use of vitamin D as a preventive therapy for wheeze attacks cannot be made until results of further trials are available. The assessment of circulating 25(OH)D concentration and the optimisation of vitamin D status to prevent acute respiratory tract infections, and to maintain skeletal and general health in preschool and school-age children with acute wheeze is worthwhile in its own right, but whether this will reduce the risk of acute wheeze attacks is unclear.
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6.
Secondary fracture prevention: Drug treatment, fall prevention and nutrition requirements.
Geusens, P, Lems, WF, Bours, S, Vd Bergh, JP
Best practice & research. Clinical rheumatology. 2019;(2):290-300
Abstract
In view of the high imminent risk for subsequent fractures, evaluation as early as possible after the fracture will result in early decisions about drug treatment, fall prevention and nutritional supplements. Drug treatment includes anti-resorptive and bone forming agents. Anti-resorptive therapy with broad spectrum fracture prevention and early anti-fracture effects are the first choice. In patients with multiple or severe VFs, the bone forming agent teriparatide should be considered. Adequate calcium and vitamin D are needed in all patients, together with appropriate nutrition, including adequate protein intake.
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7.
The year in cardiology 2018: prevention.
Reiner, Ž, Laufs, U, Cosentino, F, Landmesser, U
European heart journal. 2019;(4):336-344
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8.
The effect of sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide 1 agonists on cardiovascular disease in patients with type 2 diabetes.
Dey, AK, Groenendyk, J, Mehta, NN, Gourgari, E
Clinical cardiology. 2019;(3):406-412
Abstract
Patients with type 2 diabetes have a significantly increased risk of cardiovascular disease (CVD) compared to the general population-with CVD accounting for two out of every three deaths in patients with diabetes. In 2008, the FDA suggested that CVD risk should be evaluated for any new antidiabetic therapy, leading to a multitude of large CVD outcome trials to assess CVD risk from these medications. Interestingly, several of these outcome trials with new novel antidiabetic therapies have demonstrated a clear and definite CVD advantage at mid-term follow up in high-risk patients with T2DM. In this review, we discuss two relatively new classes of diabetic drugs, sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide 1 agonists, and their efficacy in improving cardiovascular outcomes.
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9.
Prevention: From the cradle to the grave and beyond.
Dendale, P, Scherrenberg, M, Sivakova, O, Frederix, I
European journal of preventive cardiology. 2019;(5):507-511
Abstract
Present cardiac prevention mainly focuses on risk reduction later in life, and focuses also mainly on reducing risk factors for coronary heart disease. However, multiple studies have gathered evidence that the development risk of cardiovascular disease starts early in life and that even preconceptional influences play an important role in lifetime risk. Therefore, the importance of well-timed prevention strategies to reduce cardiovascular disease is well established. In this article, we discuss different risk factors for future cardiac disease, and how we can respond to lesser known cardiac risk factors in the different stages of life.
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10.
Cardiovascular Disease in Type 2 Diabetes: A Review of Sex-Related Differences in Predisposition and Prevention.
Al-Salameh, A, Chanson, P, Bucher, S, Ringa, V, Becquemont, L
Mayo Clinic proceedings. 2019;(2):287-308
Abstract
Type 2 diabetes mellitus is a major risk factor for cardiovascular disease. However, compiled data suggest that type 2 diabetes affects the risk of cardiovascular disease differentially according to sex. In recent years, large meta-analyses have confirmed that women with type 2 diabetes have a higher relative risk of incident coronary heart disease, fatal coronary heart disease, and stroke compared with their male counterparts. The reasons for these disparities are not completely elucidated. A greater burden of cardiometabolic risk in women was proposed as a partial explanation. Indeed, several studies suggest that women experience a larger deterioration in major cardiovascular risk factors and put on more weight than do men during their transition from normoglycemia to overt type 2 diabetes. This excess weight is associated with higher levels of biomarkers of endothelial dysfunction, inflammation, and procoagulant state. Moreover, sex differences in the prescription and use of some cardiovascular drugs may compound an "existing" disparity. We searched PubMed for articles published in English and French, by using the following terms: ("cardiovascular diseases") AND ("diabetes mellitus") AND ("sex disparity" OR "sex differences" OR "sex related differences" OR "sex-related differences" OR "sex disparities"). In this article, we review the available literature on the sex aspects of primary and secondary prevention of cardiovascular disease in people with type 2 diabetes, in the predisposition to cardiovascular disease in those people, and in the control of diabetes and associated cardiovascular risk factors.